Sala-Vila, AleixGuasch-Ferre, MartaHu, Frank BSanchez-Tainta, Anabullo, MonicaSerra-Mir, MerceLopez-Sabater, CarmenSorli, Jose VAros, FernandoFiol Sala, MiquelMunoz, Miguel ASerra-Majem, LuisAlfredo Martinez, JCorella, DoloresFito, MontserratSalas-Salvado, JordiMartinez-Gonzalez, Miguel AEstruch, RamonRos, EmilioPREDIMED Investigators2024-07-092024-07-092016-01Sala-Vila A, Guasch-Ferre M, Hu FB, Sanchez-Tainta A, Bullo M, Serra-Mir M, et al. Dietary alpha-Linolenic Acid, Marine omega-3 Fatty Acids, and Mortality in a Population With High Fish Consumption: Findings From the PREvencion con Dleta MEDiterranea (PREDIMED) Study. J Am Heart Assoc. 2016 Jan;5(1):e002543.2047-9980http://hdl.handle.net/20.500.13003/17184http://hdl.handle.net/20.500.12105/20238Background-Epidemiological evidence suggests a cardioprotective role of a-linolenic acid (ALA), a plant-derived x-3 fatty acid. It is unclear whether ALA is beneficial in a background of high marine x-3 fatty acids (long-chain n-3 polyunsaturated fatty acids) intake. In persons at high cardiovascular risk from Spain, a country in which fish consumption is customarily high, we investigated whether meeting the International Society for the Study of Fatty Acids and Lipids recommendation for dietary ALA (0.7% of total energy) at baseline was related to all-cause and cardiovascular disease mortality. We also examined the effect of meeting the society's recommendation for long-chain n-3 polyunsaturated fatty acids (>= 500 mg/day). Methods and Results-We longitudinally evaluated 7202 participants in the PREvencion con DIeta MEDiterranea (PREDIMED) trial. Multivariable-adjusted Cox regressionmodels were fitted to estimate hazard ratios. ALA intake correlated towalnut consumption (r= 0.94). During a 5.9-y follow-up, 431 deaths occurred (104 cardiovascular disease, 55 coronary heart disease, 32 sudden cardiac death, 25 stroke). The hazard ratios formeeting ALArecommendation (n= 1615, 22.4%) were 0.72 (95% CI 0.56-0.92) for all-causemortality and 0.95 (95% CI 0.58-1.57) for fatal cardiovascular disease. The hazard ratios formeeting the recommendation for long-chain n-3 polyunsaturated fatty acids (n= 5452, 75.7%) were 0.84 (95% CI 0.67-1.05) for all-causemortality, 0.61 (95% CI 0.39-0.96) for fatal cardiovascular disease, 0.54 (95% CI 0.29-0.99) for fatal coronary heart disease, and 0.49 (95% CI 0.22-1.01) for sudden cardiac death. The highest reduction in all-cause mortality occurred in participants meeting both recommendations (hazard ratio 0.63 [ 95% CI 0.45-0.87]). Conclusions-In participants without prior cardiovascular disease and high fish consumption, dietary ALA, supplied mainly by walnuts and olive oil, relates inversely to all-cause mortality, whereas protection from cardiac mortality is limited to fish-derived long-chain n-3 polyunsaturated fatty acids.enghttp://creativecommons.org/licenses/by-nc/4.0/Fatty acidNutritionSudden cardiac deathreview articleAttribution-NonCommercial 4.0 International2681389051e00254310.1161/JAHA.115.002543Journal of the American Heart Associationopen accessÁcido alfa-LinolénicoModelos de Riesgos ProporcionalesAlimentos MarinosÁcidos Grasos Omega-3FemeninoDietaConducta de Reducción del RiesgoMasculinoFactores ProtectoresEstudios LongitudinalesPersona de Mediana EdadEstudios ProspectivosMedición de RiesgoEnfermedades CardiovascularesDistribución de Chi-CuadradoFactores de TiempoAnálisis MultivarianteValor NutritivoAceite de OlivaJuglansFactores de RiesgoHumanosNuecesAncianoAnciano de 80 o más AñosEspaña2-s2.0-84998579388371282800036L613254300